Eden, a nine-year-old boy, was seriously injured in the recent fighting between the Armed Forces of the Democratic Republic of the Congo and the M23 rebel group in Goma, eastern Congo. He is one of 60 wounded patients currently being treated by MSF teams and local health staff in Virunga hospital.

A young boy is carried across the ward in Virunga hospital by a nurse. He has the distant look of a patient just coming round from general anaesthesia. “His name is Eden. He has just come out of the recovery room and we’re taking him to his bed,” says the nurse. A few minutes later his cries echo down the hallway as he regains full consciousness.

When the fighting started, Eden was visiting his uncle in Goma. When they heard the first sounds of gunfire, everyone panicked. Then they heard distant shouting, voices calling: “Stay in your homes, it’s not safe outside.”

His family stayed in the living room of the house, hoping they would be safe from the shooting. Suddenly a shell came crashing in. Four family members died outright, while six others were seriously wounded, including Eden.

“We were unable to save Eden’s right leg due to the extent of the damage,” says MSF surgeon Jacky Bonnan. “But we’ve done everything we can to save his left foot, and we are hoping it will heal well.”

The five other members of Eden’s family wounded by the shell are also being treated in Virunga hospital. Eden’s uncle has also undergone surgery to amputate his right leg.“I don’t understand,” says his uncle. ”Those who stayed outside are alright, but we took cover at home and have ended up here.”

More than 480 people were wounded in less than a week in fighting that took place in and around Goma and neighbouring towns. Health facilities were unprepared for casualties on this scale.

“Hospitals were not ready to receive mass casualties,” says Jacky Bonnan. “Before MSF came to Virunga hospital, the hospital’s surgical team worked around the clock for 48 hours to stabilise patients despite a lack of resources. They did an amazing job.”

As soon as the violence eased, MSF sent a surgical team to strengthen the hospital’s case management. The team is currently performing around 10 surgical operations a day. MSF is also providing drugs and medical supplies to help with post-operative care for patients until they are ready to be discharged.